Effective January 1, 2014, a new Consumer Driven Health Plan (CDHP) with Health Savings Account (HSA) was available to faculty, academic staff and executive management. Beginning January 1, 2015, the eligible group had been expanded to include non-union support staff. The following reflect the frequently asked questions regarding the CDHP with HSA being offered at MSU. For more information on the plan, please see your Open Enrollment guide on the Open Enrollment website.
Faculty, academic staff, executive management and non-union support staff with an employment percent equal to or greater than 50% and an appointment for nine months or more (benefits-eligible) may enroll in the CDHP.
- Many preventive services (e.g. health maintenance exam, mammography screening, well-baby exams, flu shots, etc.) are covered 100% for in-network providers.
- The provider network is the same as the Community Blue PPO.
- They all have prescription drug coverage through CVS Caremark.
- Instead of paying co-pays (e.g. $20 per doctor visit), you will pay the full cost of the health care up to the annual deductible, and then 20% co-insurance until the annual out-of-pocket maximum is reached (for in-network providers), then the CDHP covers 100%.
- Instead of paying co-pays (e.g. $10 for a prescription drug), you will pay the full cost of the prescription drugs up to the annual deductible, and then 20% co-insurance until the annual out-of-pocket maximum is reached, then the CDHP covers 100%.
- Generic prescriptions for asthma, cholesterol, diabetes (injectable insulin), and antihypertensives are 100% covered without deductible or co-pay.
- There is no individual deductible or out-of-pocket maximum with family coverage. The family deductible must be met fully before the health plan will begin coverage, even if all of the deductible is paid by one family member.
- You can have a corresponding Health Savings Account to help pay for health care and prescription drugs (please see the HSA information below).
- For single coverage, the annual deductible is $2,000 and the out-of-pocket maximum is $3,000 annually for in-network providers. For out-of-network providers, the annual deductible is $4,000 and the out-of-pocket annual maximum is $6,000.
- For family coverage, the annual deductible is $4,000 and the out-of-pocket maximum is $6,000 annually for in-network providers. For out-of-network providers, the annual deductible is $8,000 and the out-of-pocket annual maximum is $12,000.
In the state of Michigan:
In-Network means using Blue Cross Blue Shield of Michigan’s Community Blue PPO network to find a doctor, hospital or medical care facility. You can call 877-354-2583 or go online at www.bcbsm.com and look for the Community Blue PPO network to find In-Network Michigan providers.
If you go to a doctor, hospital or medical care facility that is not part of the Community Blue PPO provider network, that would then be considered Out-ofNetwork. The deductibles, co-insurance percentage and out-of-pocket maximums will be higher than the In-Network amounts.
Outside the state of Michigan:
In-Network means using doctors, hospitals and medical care facilities that participate in the Blue Cross PPO Network called the “Blue Card” provider network (a toll free phone number is provided on the back of the CDHP medical ID card issued by Blue Cross Blue Shield of Michigan).
Out-of-Network is any provider that does not participate in the “Blue Card” provider network.
- You can view online tools on Blue Cross Blue Shield of Michigan’s website at www.bcbsm.com to search for the consumer cost of health care services prior to receiving care (you must register first to use the website).
- You can search for the consumer cost of prescription drugs on CVS Caremark’s website at www.caremark.com (you must register first to use the website).
- Contact your health care provider.
- Contact the administrator of the health plan (Blue Cross Blue Shield of Michigan) at 877-354-2583.
- For any remaining questions, please contact MSU HR at 517-353-4434, toll-free at 800-353-4434 or via email at SolutionsCenter@hr.msu.edu.
If you enroll in the CDHP, you are also eligible to enroll in a Health Savings Account (HSA) provided you meet the IRS regulations below:
- You must be covered by a HSA qualified high deductible health plan (like the MSU CDHP/HSA administered by Blue Cross Blue Shield of Michigan.)
- You cannot be covered by another non-high deductible medical plan (a major medical plan) or a high-deductible plan that is not compliant with IRS rules regarding HSAs.
- You cannot be covered by a health care flexible spending account (HCSA.)
Note: You cannot receive an employer contribution or contribute to your HSA plan as long as you have remaining funds in a health care flexible spending account until the end of the FSA grace period, currently April 30.
- You cannot be enrolled in Medicare (Part A, B or D); and you cannot be claimed as a dependent on another individual’s tax return.
|Full Time (90-100%)||$750.00|
|3/4 Time (65.0-89.9%)||$562.50|
|1/2 Time (50-64.9%)||$375.00|
- If enrolled during open enrollment, you will receive the University contribution in your January paycheck (subject to payroll processing deadlines, HCSA remaining balance, and employment status).
- New hires and newly eligible employees will receive the University contribution within 90 days (subject to payroll processing deadlines, HCSA remaining balance, and employment status).
c. A contribution outside of payroll deduction can also be made directly to the HSA.
- Yes. You can take money out anytime, tax-free and without penalty, as long as it’s used for qualified medical expenses. If funds are withdrawn for other purposes, you’ll pay income taxes on the withdrawal plus a 20% penalty.
- You will not be required to substantiate your withdrawals. However, you will want to keep all of your receipts for possible IRS audit.
- You will receive a Visa debit card that is connected to your HSA. You can use the debit card to pay for medical expense(e.g. doctor appointments, prescription drugs, vision, dental, etc.) at the point of service.
- You will also have access to your HSA online to pay medical invoices via the web.
- Lastly, you will be able to request a reimbursement of qualified medical expenses that were paid with non-HSA monies.